Discuss about the Health Workforce for Rural Australia.
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Date: 20/9/2016
Issue Statement
There is an acute workforce shortage in rural Australia as the junior doctors refuse to participate in the rural practice. Therefore, the health of the rural population suffers due to this shortage of doctors in the local hospitals (Russell et al., 2013). This brief will lay down the strategies to attract the junior doctors to the rural hospitals and improve the local health.
It is largely unknown what has caused the hindrance to choose rural practice by the urban trained junior doctors and go rural. The medical students from the rural areas account for about 25% of the total strength and are provided rural clinical training, yet there is a shortage of doctors due to unknown reasons (Health.gov.au, 2016).
The doctors of the rural health workforce include the obstetricians, anesthetists and GPs. This work force is aging and the junior doctors are choosing rural practice. This has widened the service gaps and it is becoming increasingly difficult to suffice.
This condition has a deep impact on the rural health as the health consequences are worsening with increasing fatal cases and making healthcare excessively expensive, which is a big burden on the health system. The waiting time is also increasing to see the GPs.
The patients from the rural and remote areas are falling sick more often than it is on the city counterparts and have to wait longer waiting times in the clinics. Chronic illnesses are getting common in the rural areas due to lack of proper treatment.
Arguably, it can be said that the issue is of growing concern in spite of the several benefits provided by the government and it can also be said that the rural doctors are still devoid of the remunerative benefits that refrain them from rural practice (Crettenden et al., 2014).
The Commonwealth and the AMA had taken several initiatives to increase the number of doctors in the rural areas, but the problem of the shortage persists. The initiatives need to reframe their strategies to make the changes happen and increase the supply of doctors to the rural areas of the country (Australian Medical Association, 2015).
The schemes and initiatives got limited mostly due to the mobility issues due to the sectional and geographical imbalances, incentive issues due to medical specialization imbalance and the regulatory issues of the government pertaining to the imbalances of the professional specializations.
This issue needs to be resolved sooner or the rural areas might face elevated levels of diseases and health risks associated with injuries and chronic illnesses. This will be common among the older population as the access to health series will continue to reduce Elkin, Spittal & Studdert (2012).
It is recommended that the government of Australia should get involved in managing and planning the demand and supply of the healthcare professionals in the rural areas. The opposing arguments state that rural healthcare is a key determinant of the national workforce productivity and supply (Federation, 2014). Therefore, the investment made in this sector will be of national interest. The financial implication on the rural health sector will result in illness prevention and health promotion due to public expenditure. Investment in certain interventions and health professionals can reduce the health professional demands (Hoyler et al., 2014). The political implication includes the introduction of reimbursement schemes by the Australian government for the health professionals working in the rural areas of the country. Introduction of rural scholarships can also encourage the rural people to take up courses on allied health.
A team of researchers has to be developed by the rural and regional health department of Australia for participatory action research for addressing the rural shortage of the medical workforce. Community engagement is also important for acquiring the accurate knowledge and recommendations for overcoming the issue. The issue can be delegated to another team of rural doctors for professional support by developing and implementing a collegiate and mentoring network (Li et al., 2014). Local government and service clubs will be included for social support coordinating professional and social supports for the GPs. Another approach that can be recommended is undertaking research on the factors influencing the decision making of careers of the medical students and fostering a culture of rural research on medical education to promote the rural practice (McGrail et al., 2012).
The proposed recommendation can be of importance to resolve the issue as community groups will be supportive of the medical workforce for their sustainability and well-being. The benefit of this strategy is that the communities can be of help in addressing the barriers to the retention and recruitment of the junior doctors in rural practice (Cheng, Joyce & Scott, 2013). The anticipated risk for the implementation of this strategy is the conflict of opinions among the community members regarding decision making that can end up in the faulty implementation of the strategy (O’Sullivan, Joyce & McGrail, 2014). The opposing arguments state that views of both the patients and the clinicians are important for developing the ideal strategy. This strategy suggests that the Australian government should invest more in the medical education and placements in the rural settings that are community-based.
The strategy will be implemented in five steps. The first step will be the formation of a task force by the rural and regional health department of Australia who will probe the problem by conducting a think tank workshop. Then the main themes will be identified by analyzing the data. The action plan will be developed by identifying the priority areas. Then the action plan will be implemented and finally, the outcomes will be evaluated.
Although the task force will have the primary responsibility for the implementation of the action plan, they will be supported by the community groups, individual clinicians, service clubs and the local government. All these bodies will work collectively on the progress of the local solutions to the identified priorities in the workshop. The timeframes, priority areas, lead organizations and the strategic actions will be set and carried as planned previously by the organizations and the individuals.
The deliverables of the solution will be focused on the priority areas of the action plan and will include more junior doctors in the rural hospitals in future. The plan will support, encourage and promote more of the international medical graduates to join the rural practice and implement their procedural skills. The after-hours services in the rural clinical settings will be made more effective in managing the rotations and triage to increase doctor availability (Blinman et al., 2012).
The time frame of the project strategy has been mapped according to the implementation of the individual components. The total project would be of 2 years of which the monitoring would be carried out throughout the project. Professional support would be for the first year and the social support would be throughout, as and when required. Research for training will be throughout and planning will be for the first six months of the initiation of the project.
An annual evaluation will be carried out for the project for determining the success of its implementation to have sustainable and sufficient medical workforce in the rural areas. The evaluation will be carried out on the number of junior doctors recruited and placed in the rural hospitals, determining the ratio of the rural population with the number of doctors and improving and maintaining this ratio across the various clinical settings and rural regions of Australia.
The proposed recommendation by the government task force should be communicated to all the community groups, individual clinicians, service clubs and the local government who are actively involved in the strategic implementation of the plan. Communication activities have to be carried out for aiming the junior doctors for the promotion of the benefits of the remote, rural and regional opportunities and demystifying the rural practice. This will clarify their myths regarding the hardships and hurdles of rural practice and attract more of the junior doctors into the rural practice voluntarily.
The recommendations will be communicated to the primary stakeholders of the project by appropriate means. Meetings and workshops will be carried out to communicate the recommendations to the stakeholders and obtain their suggestions regarding the feasibility of the project. Any amendments required will be carried out at this stage prior to implementation of the plan for its easy progress. The junior doctors and interns will be communicated by means of blogs. These blogs will be written by the medical practitioners and locums who will be sharing their experiences in the rural practice.
A communication plan will be supportive for the internal communication of the project stakeholders. For this reason, a communication plan has to be developed to effectively communication the project initiatives, proceedings and evaluation for equitable distribution of information and identify the areas of weakness (Appendix 1). The communication plan will follow the communication matrix that will demonstrate the delivery of the information to the junior doctors as well in terms of blogs and other suitable and approved media.
The communication plan will be approved by the project leader who will be leading the task force and a representative of the rural and regional health department of Australia. On approval, the proceedings will be carried out following the communication plan for the initiation of the project.
References
‘Captain’s call’ medical school won’t fix doctor shortage. (2015). Australian Medical Association. Retrieved 18 September 2016, from https://ama.com.au/ausmed/%E2%80%98captain%E2%80%99s-call%E2%80%99-medical-school-won%E2%80%99t-fix-doctor-shortage
Blinman, P. L., Grimison, P., Barton, M. B., Crossing, S., Walpole, E. T., Wong, N., … & Koczwara, B. (2012). The shortage of medical oncologists: the Australian Medical Oncologist Workforce study. Med J Aust, 196(1), 58-61.
Cheng, T. C., Joyce, C. M., & Scott, A. (2013). An empirical analysis of public and private medical practice in Australia. Health Policy, 111(1), 43-51.
Crettenden, I. F., McCarty, M. V., Fenech, B. J., Heywood, T., Taitz, M. C., & Tudman, S. (2014). How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce. Human resources for health, 12(1), 1.
Department of Health | District of Workforce Shortage. (2016). Health.gov.au. Retrieved 18 September 2016, from https://www.health.gov.au/internet/main/publishing.nsf/Content/work-st-bmp-ret-dws
Elkin, K., Spittal, M. J., & Studdert, D. M. (2012). Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia. Med J Aust, 197(8), 448-452.
Federation, A. (2014). A brief history of medical education and training in Australia.
Hoyler, M., Finlayson, S. R., McClain, C. D., Meara, J. G., & Hagander, L. (2014). Shortage of doctors, shortage of data: a review of the global surgery, obstetrics, and anesthesia workforce literature. World journal of surgery,38(2), 269-280.
Li, J., Scott, A., McGrail, M., Humphreys, J., & Witt, J. (2014). Retaining rural doctors: Doctors’ preferences for rural medical workforce incentives.Social Science & Medicine, 121, 56-64.
McGrail, M. R., Humphreys, J. S., Joyce, C. M., & Scott, A. (2012). International medical graduates mandated to practise in rural Australia are highly unsatisfied: results from a national survey of doctors. Health Policy,108(2), 133-139.
O’Sullivan, B. G., Joyce, C. M., & McGrail, M. R. (2014). Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution. Human resources for health, 12(1), 1.
Russell, D. J., Humphreys, J. S., McGrail, M. R., Cameron, W. I., & Williams, P. J. (2013). The value of survival analyses for evidence-based rural medical workforce planning. Human resources for health, 11(1), 1.
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